Vasectomy Questions and Answers

A vasectomy is a safe and effective minor surgical procedure that basically is simply a form of birth control for men who no longer want to father children or be able to get a woman pregnant. There are over a half-million vasectomies preformed in the USA every year, yet many men have numerous questions about the procedure and often find it a difficult topic to discuss with others. For those that are considering having the procedure done and are researching the facts, here are some typical questions (and their answers) that we are frequently asked by our patients.

Is It Surgery?

Yes. A vasectomy is considered to be a minor surgical procedure. Basically, the tubes that carry a man's sperm away from his testicles to be added to his semen, are cut or blocked. It's really as simple as that - a short outpatient procedure using local anesthesia that's performed at the physician's office. Although there are several variations of the procedure, at Philadelphia Urology Associates we prefer using a method called No-scalpel vasectomy, which unlike a traditional vasectomy, only requires tiny incisions and makes it a much less-invasive approach.

Am I Immediately Sterile After the Procedure?

The answer is no. Although considered in most cases to be a permanent form of achieving sterility in men, the reality is that it takes anywhere between one to six months for a man's semen to become totally free of all sperm. Simply blocking the tubes that carry the sperm away from a man's testicles where the sperm is generated to be added to his semen does not eliminate any existing sperm cells. Additionally, it takes some time to ensure that new sperm may for a short period of time still "slip" through the blocked tubes.

Until the sperm count is zero in a man's sperm, there is still a chance that he can impregnate a woman. It is therefore very important to use a condom or some other form of contraceptive during any sexual intercourse after having a vasectomy until the results and efficacy of the procedure can be confirmed. Most urologists and doctors will recommend that a patient has a minimum of one or two semen samples analyzed after the surgery to verify that the procedure was successful. Most often the samples are taken at two to four months post-operatively, but The British Andrology Society has stated recently that a single confirmation of having your semen verified to be 100% totally sperm free at four months (sixteen weeks) is sufficient. It's important to note that you simply cannot be 100% certain of complete success without verification. If you choose to have a vasectomy, don't let things like being embarrassed, being forgetful, assuming that the procedure worked, or just the inconvenience of being tested stop you from getting follow-up testing and verification. Interestingly, over a decade ago the FDA approved a vasectomy confirmation testing product named SpermCheck Vasectomy. This product actually allows men the ability to verify the efficacy of their surgery at home. Surprisingly, studies still show that the majority of patients still actually do not get confirmation of the results following having a vasectomy.

Is a Vasectomy 100% Effective?

The answer is no. Although considered to be 100% effective after confirmation that a man's semen is absolutely sperm free, in very rare instances the ends of the tubes that carry a man's sperm away from his testicles to his semen can actually "regrow" back together. A rule of thumb commonly cited is that this will occur in roughly one out of every two-thousand surgeries (0.05%). However, a study performed over a decade ago in the United Kingdom by the RCOG showed a much higher occurrence rate of over 0.4% (43,642 vasectomies reviewed with 183 instances of regrowth being confirmed and documented).

Are There Side Effects or Complications?

After having a vasectomy, most men experience some very mild discomfort or pain in the surgical area. This is usually relieved by using an athletic supporter or ice pack, plus an over the counter (non-prescription) pain reliever such as Tylenol or Advil. It is also highly recommended that you avoid any strenuous physical activity or sex for several days. There can also be a feeling of minor "irritation" associated with the stitches to the tiny incisions made during the vasectomy, but simply covering up the area with a bandage or gauze will minimize this.

As with any surgery, infections afterwards are always possible. A study performed several years ago showed that approximately two out of every one-hundred men experienced a minor short-term local infection in the surgery area. In the majority of instances, the infection was attributed to a lack of proper post-surgical hygiene by the patient.

Will It Affect My Sex Life?

No. After having a vasectomy you will continue to have normal erections, sexual intercourse, and ejaculation, but you will simply not be able to father any children. Your body will still continue to produce testosterone and other male hormones that are secreted into your blood stream. There is normally no change in an individual's sexual desire or their libido following a vasectomy.

Is a Vasectomy Reversible?

The answer is yes. However, if you are seriously thinking about having a vasectomy, you really should not think of them as being reversible. There are several reasons for this:
- Vasectomy reversal is a surgical procedure that simply has no guarantees. Typically, reversal is only successful in about half of the men who have had a vasectomy for less than ten years, and only about a quarter of the men who've had their vasectomy greater than ten years.
- The reversal surgery can be very expensive. Costs of $10,000 or more are often times incurred.
- Studies show documented evidence that men who have had vasectomies often times have an increased production of abnormal sperm cells. Even if the reversal is "mechanically" successful, many times the individual is still infertile and unable to conceive. Additionally, the higher rate of abnormal sperm cells may significantly increase the chances of birth defects occurring after successful conception.

It is often very advisable that all men choosing to have a vasectomy consider freezing some of their sperm before undergoing the procedure. Known medically as cryopreservation, this helps ensure that some of the individual's sperm is "stored" and available at some future point if the man changes his mind. Although the vast majority of men who become sterilized are satisfied with the outcome, situations can always change. This is especially true for younger childless men who perhaps need to be counseled in regard to how a vasectomy could affect them in the future. One study showed that men who had the procedure in their twenties were over ten times more likely to regret their decision and attempt a reversal later in their life than men who were older.

Questions About Having a Vasectomy?

At Philadelphia Urology Associates, Dr. Bruce Sloane is a nationally renowned specialist in Men's Health issues and Age Management Medicine. Throughout Philadelphia and the surrounding areas, patients seek his expertise about having a vasectomy. The doctors at Philadelphia Urology Associates have performed this procedure successfully on hundreds of patients. Using state-of-the-art equipment and having extensive specialized education and training, Dr. Sloane will find the treatments and solutions that will work best for you.

If you have any questions about having a vasectomy, or any other urological disorders, we urge you to contact us now online or call us at (215) 563-1199 today to discuss how we can help you!

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